NPI age
19 years
Enumerated 2007-04-16
Across 7055 active pediatrics providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 080557402 | |
| 01 (TX) | 84350S | BLUE CROSS BLUE SHILED |
| 05 (TX) | 808557401 | |
| 01 (TX) | 112708 | SUPERIOR HEALTHPLAN |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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